Diphtheria: Causes, Symptoms, Transmission, Treatment and Prevention
Diphtheria is an acute bacterial infection that typically affects the tonsils, throat, nose, and/or skin. The disease is transmitted from person to person through the inhalation of bacteria after an infected person has coughed, sneezed, or even laughed. It can also spread by handling used tissues or by using a glass used by an infected person. People can also become ill by touching infected wounds of people who have the cutaneous form of diphtheria. The diphtheria bacterium produces a toxin that makes people ill. Diphtheria can lead to respiratory problems, heart failure, paralysis, and even death.
Almost one in 10 people who contract respiratory diphtheria will die from it. Most cases of diphtheria occur among unvaccinated or inadequately vaccinated people.
Mode of transmission
Respiratory diphtheria is transmitted mainly through the air in enclosed spaces via coughing, sneezing, or saliva. Transmission also occurs through contact with contaminated objects. Cutaneous diphtheria is transmitted through direct contact with infected skin.
The disease can be transmitted even if the infected person shows no symptoms.
Symptoms
Symptoms can range from mild to severe. They usually begin two to five days after exposure. Symptoms often appear gradually, starting with a sore throat and fever.
In its early stages, diphtheria can be mistaken for a severe sore throat. Other symptoms include a low-grade fever and swollen lymph nodes (swollen glands). Diphtheria can cause skin lesions that may be painful, red, and swollen. Germ carriers are contagious for up to four weeks if they have not taken antibiotics, even if they show no symptoms.
In adults, milder forms of the disease may be present, characterized by skin conditions. These often occur in people who do not have adequate hygiene.
Diagnosis
The clinical diagnosis of diphtheria is usually based on the presence of pseudomembranous pharyngitis. Although laboratory investigations are recommended to confirm the disease, treatment must be started as soon as possible.
The diagnosis is made based on the results obtained from tissue samples taken from the affected areas.
Treatment
Treatment for respiratory diphtheria involves the use of antitoxin to prevent the toxin produced by the bacteria from damaging the body. Antibiotics can be used to kill the bacteria, both for respiratory and cutaneous infections.
Recovery from the disease is not always followed by lasting immunity, so even survivors must be immunized through vaccination.
Prevention
Diphtheria is a preventable disease through vaccination. All children registered with family doctors receive 3 doses of diphtheria-component vaccine at an 89.1% rate, starting from the age of 18 months.
In infants, the diphtheria vaccine is given intramuscularly in the thigh, and for children over 1 year old, it is given in the arm. The diphtheria vaccine is administered concurrently with other mandatory vaccines, being part of the diphtheria-tetanus-acellular pertussis (DTaP) and diphtheria-tetanus (dT) vaccine schedule.
Also, hygiene plays an important role in the prevention of the disease, and it is recommended to wash hands with soap and water and avoid sharing items with infected people.
According to the WHO, the last cases of diphtheria in Romania were recorded in 1989, its prevention being possible due to mandatory vaccination of the population.
References
https://www.cnscbt.ro/index.php/rapoarte-anuale/549-analiza-evolutiei-bolilor-transmisibile-aflate-in-supraveghere-raport-pentru-anul-2015/file
https://www.who.int/teams/immunization-vaccines-and-biologicals/policies/position-papers/diphtheria
https://doc.ro/sanatate/difteria-cauze-simptome-tratament
https://www.catena.ro/despre-difterie-si-importanta-vaccinului-antidifteric
